Earlier this month, news outlets were abuzz with the stunning (if slightly icky) pictures of a lamb foetus that scientists at the Children’s Hospital of Philadelphia had managed to gestate for four weeks in an artificial womb before it was “born” prematurely at 107 days’ gestation. The time may still be a way off when the same technology can reliably be used for human foetuses. The obvious hope, though, is that the use of artificial wombs, or “ectogenesis”, will eventually allow us to sustain the lives of prematurely born babies too underdeveloped to survive in the extra-uterine environment, Or, by enabling premature babies to continue their development for longer, it will forestall any number of physiological problems that result from premature birth.
While such a capability would no doubt mark a huge leap forward for neonatal medicine, considerably less attention has been paid to what it would mean for abortion rights. Supposing that artificial womb technology could one day sustain the life of even an early embryo all the way through to viability (the point at which a foetus can survive outside the uterus), how might this impact the argument for the right to abort a pregnancy?
In fact, moral philosophers debating reproductive rights have already addressed themselves to the question of what artificial wombs would mean for the ethics of abortion. Some have suggested that it could signal the end of bitter disagreement about abortion rights, especially in the United States. A ready availability of artificial wombs would enable women to exercise bodily control and rid their body of an unwanted foetus and the burdens of pregnancy without necessitating the death of the foetus. The most prominent justification for abortion rights in the public arena is the claim that women have the right to control what happens to their own bodies, including the right to end the parasitic living of the foetus upon them should they so choose. Of course, pre-viability, ejecting the foetus inevitably spells its death. But the most mainstream abortion rights argument tends not to argue for a right to decide the death of the foetus per se, only the right to end a pregnancy notwithstanding the unavoidability of foetal death.
Artificial wombs would seriously uproot this justification by providing the means to end pregnancy without killing the foetus. The mantra “my body, my choice” will not have much purchase once women’s bodies are taken out of the equation. This is especially so where the costs and risks of transferring the foetus to an artificial womb are no greater for the woman than that of termination. In short, for the same price, she can eject the foetus whilst keeping it alive. In such a scenario, it seems that the right to abortion could only be cashed out as the specific right to the death of the foetus.
Ethicists on both sides of the pro-life/pro-choice divide have expressed scepticism about whether any such right could exist. For example, perhaps the most famous defence of the moral permissibility of abortion was posited by the philosopher Judith Jarvis Thomson, who argued that the heavy burdens of pregnancy entail that gestation is an act of Good Samaritanism – the kind of gratuitous act that no one could be required to undertake even in order to keep another person alive. However, Thomson’s defence conceded that there is no “right to secure the death of the pre-born child”. In other words, she defended the right to extract or evacuate the foetus, not the specific right to terminate its life. In his (pro-life) 2015 book The Ethics of Abortion, Christopher Kaczor remarks that if even the most stalwart intellectual defenders of abortion deny the right to secure foetal death, few supporters of abortion rights are likely to disagree. “If the medical community refused to perform terminal abortions and would only perform evacuation abortions,” he remarks, “Then the abortion debate as we know it today would be over.”
So, would artificial wombs spell the end of disagreement about abortion? Along with Kaczor, pro-life advocates might look forward to the prospect of a solution amenable to everyone (although they might also harbour some reservations – the prospect does, after all, involve one of the social conservative’s pet hates, new reproductive technologies). Of course, simplifying things this way neglects the far-reaching socio-economic ramifications of swapping abortion for artificial gestation on a tremendous scale – the massive influx of children available for adoption and possibly in need of social care; the astronomical expense of providing an artificial womb alternative for nearly all of the abortions that are performed, and so on. Factors such as these may mean that artificial wombs are unlikely to be developed as a real option to abortion any time in the near future. But the salient hypothetical question remains. How would defenders of abortion rights react if it did become a reality?
I imagine that most supporters of abortion rights will feel no small amount of consternation about a situation in which there is no right to abortion, but only to evacuation of a foetus into an artificial womb. Would they be left with no argument for the right to termination? As we have seen, the bodily autonomy interest would not be an adequate defence of abortion in the hypothesised scenario. But liberation from the burdens of pregnancy is not the only, or indeed the main, interest women have in abortion. The other, and arguably more significant, interest protected by abortion rights is the interest in procreative control: the right to decide whether and when one will become a parent. This interest was vindicated by the US Supreme Court in Roe v Wade when it grounded the constitutional right to abortion in a previously recognised right to be “free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child”.
Becoming a parent is one of the most personal, profound and identity-changing events that can happen to a person. Nothing less than the right to termination will protect the interest in controlling when and if this happens. It may be objected that the availability of adoption post-artificial gestation would adequately protect that interest, since no woman would be forced to become a mother in the social sense. I think it plainly clear, though, that what many women are seeking to avoid through abortion, far more so than the burdens of pregnancy, is either one of two scenarios: becoming a mother (or a mother again), or having a biological child adopted by others. Both are meaningful interests. While some might deny the objective importance of pure biological relations, there is no denying their emotional resonance for many (which is why adopted children often seek out their genetic parents). Preventing a situation whereby there exist biological progeny with whom one is unconnected can be significant human interest in itself.
The procreative control justification will no doubt be far from convincing to pro-life advocates that view the foetus as the moral equivalent of a born child, and abortion as tantamount to homicide. This in turn brings the longstanding debate about the intrinsic moral nature of the foetus to the centre of the discussion. If the gestating embryo or foetus has a very low independent moral value, and abortion is not very different from contraception, then the interest in procreative control is surely strong enough to entrench abortion rights, even in a future with artificial wombs. If, on the other hand, opponents of abortion are right to view the foetus as no morally different from a five-year-old child, then the interest in preventing the mere existence of biological children will be far too thin a justification for the general right to termination. The one certainty is that in a future world where artificial wombs are made readily available, defenders of abortion rights will need to adapt their defence of abortion to shift the emphasis from women’s control of their bodies onto the significant interest in controlling our reproductive destiny.
Kate Greasley is a lecturer in law at University College London who specialises in abortion law and ethics, and am the author of a recent book entitled Arguments About Abortion, published by Oxford University Press.